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HomeMy WebLinkAbout0226 MAIN STREET (CENT.) - Health (2) LA = Ma in. Street (Cent.) rville 09. _ 110 i TOWN OF BARNSTABLE LOCATION SfCU,•c- SEWAGE# A " �,66 VILLAGEL—v1, ASSESSOR'S MAP&PARCEL — 0 g INSTALLER'S NAME&PHONE NO. r SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO.OF BEDROOMS .wd- or "re- OWNER Sys PERMIT DATE: ®61 COMPLIANCE DATE: + Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on '"t site or within 200 feet of leaching facility) x: Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachin facility) h Feet FURNISHED BYe . y t� rVINO MONO qb 4 �, No. / c) — I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:- es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for 30isposal *pstpm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location 4ddress oi.LLot No. Jr\ S�(C fi' Owner's Name,Address,and Tel.No. Q S ;e &Nz"K Assessor's Map/Parcel 1A Installer's Name,Address,and Tel.No. e r D sign am er's Ne,Address,and Tel.No. I fpd �.�-r � M ---4 013k AWA"^ ne VI x Type of Building: 'r Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) (� /y- gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar alth. _- Sig Date "l' Application Approved by Date — Application Disapproved by Date for the following reasons Permit No. t%� ' Date Issued :feria=_ - - - - - i y j n.i/ 41i L`i..� No. O — 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS f 2pplitatlon for Disposal *, pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System , ndividual Components Location Address or Lot No. N �q Owner's Name,Address,and Tel.No. t�S}; ( �;•r"� Assessor's Map/Parcel Z49CA"" Q Installer's Name,Address,and Tel No. _ Designer's Name,Address,and Tel.No. 4�"^ �Cn C.T; . cIL Marfi�na ��° Ift.+-r: Ci)`t l ^� $4r 0",U+•� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �►� gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) qrS,j,.�� Lr �. 1, 4- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by 4BoarHealth. Sid-- Date Application Approved by Date t-_ Application Disapproved by Date for the following reasons Permit No. _20/ k Date Issued -- - --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by C-• r O at f -�.•: has been constructed in accor ance with the provisions of Title 5 a/9 the for Disposal System Construction Permit No. dated Installer i Designer CA o er #bedrooms V I& Approved design flow A 1,C! gpd i n The issuance of thi perm' shall not be construed as a guarantee that the system will fi(n ti n designed). Date Inspector 1 ti -----=--------------------------------------------------------------------------------------------------------------------------------- No. 1 Ol ei- /12 Fee _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade�,//.} Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date �- Approved by (�/ rT Nov 08 03 10: 58a Robert Michael Perri 508-896-4861 P. 1 CAPE COD ENGINEERING, INC Robert M. Perry*P.E. 50 Leland Road Brewster,MA 02631 Tel./Fax 508-896-486I bobppMry@capecod.net November 7, 2003 Town of Barnstable Health Department 367 Main Street Hyannis,MA 02601 Re: 226 Main Street,Centerville; Bonita Lesley Residence To the Health Department, At the request of Pratt Construction Co.,on November 6,2003 we supervised a general inspection of the septic system existing at the referenced property. The septic tank distribution box and leach pit were uncovered. Due to landscape considerations we were limited to spot checks of the concentric stone field surrounding the leach pit. Soil quality is a medium to coarse mineral layer texture around the leach pit.The existing system shows no'sign of distress or failure. A flow test was conducted during which approximately 800 gallons of water was introduced to the leach pit. This quantity of water was disposed of through the action of the leach pit within 12 hours. From this result we conclude that the functional capacity of the existing system is in excess of 700 gallons per day. Please contact me directly should you have any questions. Sincerely, Cape Cod En - eering,Inc. Robert _Pery Cc:Tracy Pratt,Pratt Construction Co. TOWN-OF B.ARNSTABLE LOCATION D(D SEWAGE # VILL.AG �ta, Mf" - ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO7:�::�"�i� r SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) O NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER' l BUILDER OR OWNER I DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No e Yawl ` t 1 c( -NL y .r . ..... . THE COMMONWEALTH OF MASSACHUSETTS OAR® OF HEALTH --.....OF........................................ Appliratiou for Biipns.a1 Works Tomitrurtiou Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (k an Individual Sewage Disposal System at: ...................'.,�u---.....:---- ' '"r��'�._l. .. c?-----:--I-----.......---- ------ " Location-Address f-P _ ...S.../ --------------------C - -------------------------------------------------- Ow _.......__�.L_.o.t...N..o... ..... - er ^r •Address ------------------ "'�� Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------------------------------•-•----•---•... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length-------_........ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------_-------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ W -----------------------------------------•-------------------.............................................................................................. 0 Description of Soil..........................................................................................................................-....................-------.................. x W ---------------- ----------------------------------------' ------------------ - ------------- --------------------------•••- 9 V 1\ re of Repairs or Alterations Answer when applicable_ _GNU _�t1�1 �1 !( _t_tfli_ ________________________ ............. [.1-SQ.0......."S&L................................................................................................. TT Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'L--'7711E i of the State Sanitary'Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha ee 'ssued oard of health. Signe .. ---•-••• . .. -- ............................................. l �.. �. D t Application Approved BY .a� ... =-------•••-----•-- ...... • . . •--•----- ate Application Disapproved for the following reasons---------------••------------------•----------------------............-•••-•-------•-••......-••-••.......... -•••-••-•••-•••.............••••....-•-••••••--•-•••---•••••--•••••••--•----------•-•----•--•••••-•-•-••--••-••••••-•••--••--••-•--•-----•-•---•--••-•••••----••-------••-••-••-----•--•-••---...------ Date PermitNo.......... .. ---------- Issued-------------------------------------------------------- Date FEB 4sl...... THE COMMONWEALTHOF MASSACHUSETTS BOARD, OF HEALTH Appliration for Mipwial Mirks Tonstrudian Prrutilt Application is hereby made for Permit to Construct ( ) or Repair (�n Individual Sewage Disposal System at __. � _. _.... ..._._.._ .� 1. ---------- Add io 9 ss t o. ----_... ----._--- - - °.-. Owner - Address a .._ ....... . . ._. . .. -••-•---••._._....-••-..._.....•..............:.... G��._•-- --• -...•-•.. ........... Installer� Addres� UType of Building Size Lot____________________________Sq. feet 1—, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building ____________________________ No. of persons.______________________:___ Showers ( ) = Cafeteria ( ) a' Other fixtures ----•----- .........-------•-------••--•---------------------....._..---------------•------._..._..-------------...-----••-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons - Length................ Width................ Diameter__-_____________ Depth................ x Disposal Trench—No_ ____________________ Width......._............ Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No----_----_-------- Diameter.................... Depth below inlet................._Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1-4 Percolation Test Results Performed by.......................................................................... Date........................................ - a Test Pit No. I................minutes per inch Depth of Test. Pit.................... Depth to ground water........................ rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --•-•----=--------------•--•-•----...---•-----._.:..------------._..:..--------------•-••--..._..--•........................................................ 0 Description of Soil.............................................................................................................................................•.......................... "� ----------------------------------------------------•---------•------------------------......---•----•••-- ---•-•-- , •--•- ...................................... 0 of Re airs or Alterratti s—Answer when a plicable_.{y`. .. --•--• .-- -.._ ._... re ••-••------------------------• Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TlT 1..0 i of the State Sanitary Code. The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha e issued board of health. Signe4 _.w ,` :: i..s- Application Approved BY ` 6? 1'.. .....�`_'.�-...�---....----••-•---•- - ----- ate ........... Y Application Disapproved for the following reasons:---•-•---•-•---•------------------=---------•----------------•-----------------[----------•--•---•-•-•--•------ ........................-..........................................................................................................................--•--•-•-•----•--•------••-•-•--••••-•._.._. Date Permit No............. ------—---- � ------- Issued-----•-•--............................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c- .......O F......... W.40 .:. ............................................ a�t�lt�ttr�e THIS IS TO CERTIFY, That the Individual Sewage Disposal-System constructed ( ) or Repaired ( ) by - --------------------------------------------------------------------------------------------------------------------------- E '�,,�-_ •�•----- �-1'--•• Installer at...................................._ fif1 -�-�l.----- ev, - r has been ins�iled m accorddnCe'Witn the provisions of Tiii.E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.----- o dated-.--_____;_- :�_ :-. _ � :_ 7e---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU AN E THAT YI'IE SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------` �.`�.. .:. ................................... Inspector..... ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH tn/ ...............OF........... ..................................... ..... 3 ...... --� f FEE ...=- - Dioposal Works Tonstrmnatt anti# Permission is hereby granted_____._____ -> �' ;z? 't-.---,�.............•-° ---•,- ______-•--••---•--_________-__________----•---•-_--__-___-_____ to Construct ( ) or Repair ( } an"individual Sewage Disposal System at ' : . ......... 1,� -- ;.:. ..._..---•C:^�-e't_g--y--•-•---Street.............•-••--•_--- ---•--•- as shown on the application for Disposal Works Construction Permit No.4-______._= : Dated r - .-.p ........ r� DATE---_ ----------------------------------- FORM �ard•-otr a1�6"r:�._:_.a:t�...._ -•-•-------- - _ d --- 1255 �HOBBS & WARREN. INC.. PUBLISHERS - LOCATION a SEWAGE PERMIT NO. SF V I ,LPL A G EE L NSTA LIER'S NAME ADDRESS B U I L D E R OR OWN ER DATE PERMIT ISSUED, DATE COMPLIANCE ISSUED - � W_�S loco `r"'- TA►,K NO N i �b o. THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEP)L-rLj .........OF......... ----------- AmIfir-ation for Miposal 19orkii Tonstrurtion Prrutit Application is hereby made for a Permit to Construct or Repair ( d-ja'n Individual Sewage Disposal System at: ................................................................................................ Location-Address or Lot No. ... . .......................... ............... . ....................... ................................................................................................ ner Address .... ............................................ ...................................................... Gam... Installer Address T e of Building,--" Size Lot............................Sq. feet U Dwelling—IrNo. of Bedrooms............................................Expansion Attic Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P., Other fixtures ...................................................................................................................................................... Design Flow.........................:..................gallons per person per day. Total daily flow.....--.....................................gallons. W 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter...----......... Depth................ Disposal-sal-Tfenchl—No..................... Width.................... Total Length.................--. Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.........---.--..... Depth below inlet..........._...._... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date....' -------------------------- Test Pit No. I................minutes per inch Depth of Test Pit....--.............. Depth to ground water..--.................--. 97-1 Test Pit No.'2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ----------------------------------.....................................................................................--------*....*----------------------- 0 Description of Soil---- ...... ----- ------- ---------------- ................................................. U .................................... .... ........ ............................................................................................... W ............... .......................................................................................... ;Z------ --00� ............................................ U Nature of Repairs or Alterations—Answer when applicable.......... 4?---- ............................................. ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI I TIM 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been/sued;b 0�t e oar ;if eh&h.y./h Signed. 74 0 Me� ... .... .. ... ..... ----- >11, do ApplicationApproved By..... ............ ............. .... ................................... ........................ Date Application Disapproved for e following reasons:............................................................................................................... . .......................................................................................................... .. .......................................................................... .................... Permit No........... .................... Issued............%.................... .— Date .............. Date ------------------------------------------------ No THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t d'.. .----..-.OF...-..--.{.' !rt -------- r—. 'k---•--•..........................• 'Appliration f for Disposal Works Tnnstrnrtinn rumit Application is hereby made for a Permit to Construct ( ) or Repair (%.-) an Individual Sewage Disposal System at ...... .......... a.i5..-,�. ......w.�J"t ` : 'dt a>c%-----------------------------•---....-----••----...----...---••-•-----------......-----........_. t; g Location-Address or Lot No. ...... ..7 ........................................ ._. _____ ______________________________•____---............................._...._.....__._._............_. fOwner Address a .C......*.../` lart•:c° ......:�,o-c. :......m.dr:. ..---•----'•-----------------------------------------------------••--------•--......_.......-----• ` Installer Address e of Building ,,�' Size Lot............................Sq. feet I-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a` Other_T e of Building ______________ No. of 4 yP g --------•----- persons ------------------._._Showers ( ) — Cafeteria ( ) 0 Other fixtures ____________________----•------------------------ ---• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below.inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ 1-4 Nest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f14 ITest Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... P4 -•-•----•---•--•-------•-----•-------•-•------•--'--•-•--------------•-•-'-•------------------------........------------.....__--=........................... o Description of Soil......,.., ......................•-----'•----- c7`+rF..::� .......r-�e•.....----^-�'" rftl'tF.• 7r ----._._... --------—••••-------------------.-^-----—^-----•---- W rf VNature of Repairs or Alterations-Answer when applicable........... Wi......"` .:*'%F'.......................................................... --------------------------•-•--•------•-'--------•----------••-------•'----••---•-•-.....-----------•-----------•----------____•--•------•---•--•--•._____.---•-•--•-' -•---------------------........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of L I A I,i:, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been Xssued by thgboar&of health. 3— ' ApplicationApproved By'-- •' '------•-•..................•-------.....__.----....._..........--------....._.._. ...................................-•-•- Date Application Disapproved for the following reasons:---•---••-•--•-----•----•-------•--•----•--------------•---•----------------••---------•--..._--'----.....:..••- ;z ` �: 4"'`�'��-^� 'wl �` �� g�j Date PermitNo. -• % ._._.... Issued---•----------------•--•--•'-------.......-------------- Date ?' THE COMMONWEALTH OF MASSACHUSETTS t -- t - BOARD .OF HEALTH _. . 4 k ..............OF...:w:.3 r.-:... .:-t..rz ' '. f_:............................... f9rdifirate of ToutpfiFanrr TH.I.�Y_A CERTIFY That/the Individual Sewage Disposal System constructed ( ) or Repaired � fP r > Installer --- w 4XJ� has been installed in accordance with the provisions of T�� ;4!§he State Sanitary tod it-d��bed in the application for Disposal Works Construction Permit No_________________________________________ dated----------------------____...................... THE ISSVA�GE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFACTORY. DATE................ ..., ................................................ Inspector................-- --- ................... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w a .........OF..... No. FEE.' f Dispogai Works Tons it r�ion Vamite Permission is hereby granted... ��+ ' ___ ✓` ' to Construct ) orb /eta; O ^}''an Individual Sewage Disposal System at .No.-----"` .......�:Al?24�.�.a� �-----�; -•--- r :.................... ,--�" s r ✓r`` w JStreet as shown on the application for-Disposal Works Construction Permit N .__ _________ Dated------_............................_...... ---------------••----•• - ---C----------------------- ~ Board of Health DATE.............•-•---•'--•---•--••-----••--------•-----•-----_--• ...,..... FORM 1255 A. M. SULKIN, INC., BOSTON t' LOCAT ION Gt !'h I SEWAGE PERM T NO. 7 VILLAGE - (� o INSTA LLE 'S NAME & ADDRESS C.A B U It D E R OR OWNER 777 DATE PERMIT ISSUED ^ 3� ._ DATE COMPLIANCE ISSUED -- �� z� E la _ 10, y � f3 S ' J F:zs. 1�d.J moo..--•--- �...:— � . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ... ...............OF..................................... ........ ..............................•. Appliratiun -for Disposal Works Tontitrurtion Vamit Application is herebymade for a Permit to Construct (/) or Repair ( ) an Individual Sewage Disposal System at ------------------------ -----...........•--- . . •----------------•---------•••-•------- --••-•----------------------------••. C7 " �E Location-Address or Lot N v Owner Address Installer Address �O� Q Type of Building Size Lot.... ..................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (u®) Garbage Grinder ( ) Other—Type of Building _______________________--- No. of persons............................ Showers ( ) — Cafeteria ( ) Qa' Other fixtures -------------------------------- ---------------------------------- W Design Flow....................__..__.._............._gallons per person per day. Total daily flow..........3.J�........................gallons. WSeptic Tank—Liquid capacity/PRk.gallons Length................ Width---------------- Diameter-----........... Depth--_.--_--_------ x Disposal Trench—No-____________________ Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... ---------- Diameter.................... Depth below inlet.................... Total leaching area--_-_-.----..-____sq. ft. z Other Distribution box Dosing tank ( ) aPercolation Test Results Performed-by-------------------------------------------------------------------------- Date-----•-••---•--------------------.----- ,� Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water..-------_--._-._-.-__-- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--.--_-_--._____-_-._. P4 --------------------------------------------------------•-••------••----------•-•---------------•-------------••---------•--...----.....--• ----------------- ODescription of Soil-------------- ---------------------------------•• - --------------------------------------- e'llms. S/9 N-� -� r� - - - ----------------------------------------------------------------------------------------•........-----------•-----•--•----•----------. W V Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- -------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------- ---------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ued b �_�theboaa.�d of health. �,��,D Signed---- ( � d"" '3©--------- Application -27 ---------------------------------------------------------------------- ----------------A roved B �� Da , " PPY .......-•.............•---••-•----•---•--------•-•-•--••---•---•--------------• ............................------••-•-. Date Application Disapproved for the following reasons:-•-•---•--•.......................•-•-•-•--•----------...-----...................-•----------•------------••---. -----------------------•-------------•--------_----.----------------•---••--•-•-•-•----...-•--••----------•---...-•-•---------------•--..__._.......------............----------------....-------••----- Permit No------3_--Z.................................... Issued------. vl Da �S 3 ¢Ta ::.1 F>aa.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -.. ..... .... _ ....... -- .OF.................................... - - ................... -- ....._ ApV irtttion -for Uiopoottl Worko Tonotrnrtion Vrrtitit Application is hereby made for a Permit to Construct (/) or Repair ( ) an Individual Sewage Disposal System at: ; �✓1 i-1 i W 5 T. C C k rT�V 11 L 1 " L (DI 1 1 -- -•-••-----------•••••...............•. .... ....----•.............•••-•-•••••-•--•--•-•--------•-----••-•------------•---............-•--- Location-Address or Lot No. . ..............••••••••-----•--•-•••••.......................... Owner Address f 1 1(rC Ik CJ....S t 2. ----•--••-----------------------------------. -----------------------------------------••--••-••----•. .•-r-- q Installer Address UType of Building Size Lot...._..�;....U©......_.S feet Dwelling—No. of Bedrooms._._` .................................Expansion Attic (0o) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No, of persons..._-------________---_-_._- Showers ( ) — Cafeteria ( ) Otherfixtures ---------•--•-•--•------------------•-------------------.....----•---------------------_.---- W Design Flow--------------------------------------------gallons per person per day. Total daily flow----------- ----------------.....gallons. WSeptic "Tank—Liquid capacityf r_!V _.gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No--------------------- Width-------------------- Total Length_.-.-_.-.-__-_____. Total leaching area--------------------sq. ft. Seepage Pit No-------------------- Diameter____________________ Depth below inlet.................... Total leaching area------------------sq. ft. z Other Distribution box ( )� Dosing tank ( ) Percolation Test Results Performed by---------------•---....................................................... Date----.--..-.-.-.----_-------.----------.. Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-----------------...__-. f14 Test Pit No. 2................minutes per inch Depth of Test Pit-------.------------ Depth to ground water.---. ---_-.-.__-__-... P4 ------------- -------- --------------------- O Description of Soil -------------••----•----------------- ------....----------------------- W V Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. 3 9 � Signed....... ... ----•----•--- ��.u«� a .. Date /� Application Approved By_____________ __________ Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------•- ---••--------------------------------------------------------------------------- ------------------ Date PermitNo...... ' f^ ................................. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r GLG t /'l�ft� r,4/fit c- OF............ ...............................................I...................... OvIrrtifirate of 0.1,11mViianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................A-'t '.1..--•------..._(./fir t"eI_'-T!!I -------- ------------------- - ---------------------------------------------------••-------------.......••--•-••--••••-•••--•----- Installer at------------- / - f �11�t_ S T..... r j�` �<< -------------•--.-----•----- ----- ------- has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated----- .-:------____-_-__-_--_-------_-___--__---- THE• ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................................................----.............. Inspector-------------------------:-----------------------------------------------•--------- THE COMMONWEALTH OF MASSACHUSETTS ""- BOARD OF HEALTH /'• ` " .f.: _ - No.--------a-'-----•---- FEE........................ MnVagal Norkii Cllonstr �tion Vrrmit Permission is hereby granted........ f ............... '. r..1.c. .t .......... --------------------•---•----•--•-•-•------....................................................... to Construct or Repair ( ) an Individual Sewage Disposal $system at No---------ae�--= /--//a i' ' r r� = r /"!f r l�/rt ` •-- --------------------- ------- = - - ------ ----- Street as shown on the application for Disposal Works Construction Permit Jo------ ------ Dated_...__!....:.. :...... ...2..._.... /, ✓ , u_.. Board of Hyalth DATE ------- /f FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y 111 2- ' 1g, i � � m Jo _ Y / A404 � � GAL , � /p• P•r, 1 F GA4 Q- I 13 f 1.1 Z7. `" �p t 20" Gr d ss. E'5 M T ; ._ 1©5•dl I -- Li Bti x �f F• �;+#r. a;nak CESZTtFtE:t� pLb'T" PL.l�U �--aft a *�o s eQTMV►LL.it � 40 Cr.WTit=--f T"A-r TNG FauhlbAl'+orj5t-low+.i Pl--A�..1( �Z�FcRE�..1GE t W C--OW COAlPLYS W ITN TWG: SI VS t_tWC AhID SETt3,At1G VGQUIIZEAIA& -iTS OF TNT pI.AF.I '02. '�'ow�.1 n� �At2.WSTAT3l..E / 0 L / y O L l`-rr REGiS'rC-;MU LAWo 5UZVc`(oV-S Tt-AIS QL-AW IS +...IOT BQ.SE"U 0+-4 A-W OSTE(2•VkL-LC. o J1rCA5S. U-4-9 'C'OAAEWT 5UZVr-( 4 Ti4E-- SldawLr) APPt_.t CA."-r hb`r BG U'SC-Q TO tbfs TEPM+Nr Lt .01- 6Uyt C/-o t-al j't /< rib t y _ i 1 � I•{,��J�� �,,`. � �+ J "t"_r '"ice � I 'yt:'.�•: i � � _L: /` '�, ;�)•`!' 1 � (,q__a�.__.��i.. 1= •% /f � lam. ��: \ ` I , ! }, --_— __;!h,/ {"4 r,,1 ".� .... ,-� (� _. ! -J <: , .._�_. 'fir ' / ► lt-v _ r".'_(. _:' - - r i, ►.._,'. r1ew A' L .rr. i I fl iJ'� � •C"J, � rfr• ,I( �� ' �/ '� i � �lr.- ,• ir'.._• .„:O�..... l�' � ... a, �r tti114 hV �-+--- fir���_ I, •� � i'.; :.�/ � t BA!>1hJ I _i '��� T''r �.1r �•� _ . 1 ^ L „!J t I J v t ` `J`1.,1 :7 CI f •. f•./,.f;Y//..'fi"'a�; •' �,! !. �/ , .. flf''', �. � ,"�. '•',i a'p,•W +t'+Y f I — �__ __�.�__. CiT�t dies•...-/ / `� _ ZZZ NOTES 1. DATUM IS NAVD 88 2. MUNICIPAL WATER IS E CI tNGG G�ea ash,Q ` 3. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE Route 28 P 4. CONTRACTOR SHALL BE RESPONSIBLE FOR Sy/Pia 0 Qos CALLING DIGSAFE (1-888-344-7233) AND Old o $40 VERIFYING THE LOCATION OF ALL UNDERGROUND & �,o OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. Pine X \ 5. EXISTING SEPTIC LOCATION PER TIE—CARD ON \ FILE WITH THE TOWN. ZONING LOT AREA SETBACK 21,990t SQ. FT. , 6. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. �o�c / LINE 4.50t ACRES 7. PIPE JOINTS TO BE MADE WATERTIGHT. Q j 8. CONSTRUCTION DETAILS TO BE IN ACCORDANCE ROPOSED , 'o. WITH 10 CMR 15.000 (TITLE 5.) 80 INV. 9. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. 10. COMPONENTS NOT TO BE BACKFILLED OR �• CONCEALED WITHOUT INSPECTION BY BOARD OF ` HEALTH AND PERMISSION OBTAINED FROM BOARD O/� U MAP /�, p O OF HEALTH. LVCt15 lVIC1i— �ti k / O SCALE 1 =2000 t ASSESSORS MAP 209 PARCEL 110 LOCUS IS WITHIN FEMA FLOOD ZONE X -(AREA OF MINIMAL FLOOD HAZARD) AS g SHOWN ON COMMUNITY PANEL #25001 CO563J 5 DATED 7/16/2014 _ BRICK PATIO SUMMARY V� � ZONINGNG ROPOSE POOL ROPOSED 4� : SCH40 Z TU8 INV. r PVC @ 2% FOR FUTURE ZONING DISTRICT: RC RESIDENTIAL DISTRICT LAWN 32.90 SEPTIC CONNECTION. BOTH ENDS TO BE MIN. LOT SIZE 43,560 S.F. o CAPPED. MIN. LOT FRONTAGE 20' ,i Ho MIN. LOT WIDTH 100' TUB MIN. FRONT SETBACK 20' $ - MIN. SIDE SETBACIK 10 MIN. REAR SETBACK - 10' MAX. BUILDING HEIGHT 30' 10 FT WATER ' SITE IS LOCATED VATHIN THE RESOURCE EASEMENT .�o c9o. PROTECTION OVERLAY DISTRICT I GINNER OF RECORD r, 56 EXISTING BONITA LESUE, TRUSTEE DR AVEDY DWELLING THE BONITA LESLIIE LIVING TRUST DATED JULY 15, 2015 TOF=33.0 226 MAIN STREET FFLR=33.9 BARNSTABLE (CENTERVILLE), MA 02632 \ REFERENCES DB 29033 PG 74 P13 434 PG 68 (PARCEL A) \ P8 315 PG 22 (LOT 11 A) LEGEND s 1 99— EXISTING CONTOUR 60 —[991 PROPOSED CONTOUR Y SITE PLAN -- OF 198.4] PROPOSED SPOT EL. TH1 TEST HOLE 2g . ` R, 30 #226 I�JIIAIN STREET z .00 CENTERVIL.LE, MA ® CATCH BASIN �`'3�.27' �}� o �. U PREPARED FOR TIUTY POLE 6 FIRE HYDRANT EDWARD E. & -BONITA M. LESLIE UG'HT 28 APPROXIMATE LOCATION OF a �_j"OF s4q , &Ivkot W WATER LINE EXISTING WATERLINE (V.i.F.) ��v DAIV ��'� gssy�, DATE: APRIL 24, 2019 J 1 ( !t A. �fi' �`1 DANIELA. O JALA s OJALA °.A off 508-362-4541 r`IVIL fax 508-362-9880 G GAS LINE �oo.�kiT93�r tiro 46502 4 downcape.com OHE— OVERHEAD ELECATIC �� FFssNo oF`. ,���` °cr ���kk.. . —X—X— FENCE URy�� fissip At ENG�� dOwo rape !A�"keerh7f, �/IC. NOM NM ALL SYMMS MAY AMM IN Dw►wM civil engineers Scale:1 20' land surveyors 1 —T-- 939 Main Street ( Rte 6A) n �r a �0 20 30 4o so FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 DC �j'03-0J 24 03-024LESLIE.DWG